KNOW PTSD: 5 Ways to Improve Distress Tolerance
Our ability to handle the difficult parts of life without being overwhelmed is our distress tolerance (AKA: window of tolerance or therapeutic window). This doesn’t mean that the difficult parts don’t make us upset, rather it means that our level of upset is tolerable.
Unfortunately, most people are never taught to tolerate unpleasant feelings. In fact, we are often taught to be very intolerant of them. We are taught to believe that negative emotions are to be avoided at all costs. This means that most peoples distress tolerance is very limited.
If we are struggling with trauma and PTSD our distress tolerance can become even smaller. This can occur for two reasons: First because a common symptom of PTSD is avoidance of reminders of the events and feeling linked to the PTSD. Second because PTSD is, by definition, an overwhelming of our ability to deal. Each time our trauma related emotions overwhelm us we become less willing to try to tolerate our emotions; thus, our distress tolerance shrinks.
But having little or no distress tolerance is not written in stone. There are many things we can do to expand our ability to tolerate distressing feelings. Working on healing major unresolved traumas should be done with the support and help of a trained professional. But learning to expand our distress tolerance and become more capable of dealing with regular daily distresses can be achieved with learning and practicing new skills.
Here are 5 ways that we can expand our distress tolerance.
- Describe it differently: What we tell ourselves about what we are feeling has a huge impact on how we experience those feelings. When we tell ourselves that “I can’t take this”, “I shouldn’t have to feel this way”, “This will kill me” or any other way that we tell ourselves that we cannot tolerate these feelings we are shrinking our distress tolerance. Shifting how we describe how we experience our negative emotions can drastically improve our tolerance of them. If we tell ourselves “This sucks, but I can get through this” we will tolerate the experience better. If we tell ourselves “I don’t like feeling this way but feeling sad because something sad has happened is appropriate”, we will be more tolerant of those sad feelings. How we talk to ourselves about our feelings directly impacts our tolerance of them.
- Modulate the experience: When an emotion is very intense it can be useful to adjust our contact with it in order successfully tolerate or work through it. Some emotions are intense and can only be felt intensely but we can still modulate our experience of it by taking breaks from it and getting through it in doses. We can use distraction or disconnection in order to create pauses that allow us to rest and recoup. Distraction and disconnection tools should be used to take breaks and not avoid permanently.
- 5 Distraction tools:
- Read a book
- Watch a movie
- Crank up some music
- Spend time with friends who will distract you
- Help someone else, focusing on someone else can help us put aside our own struggles
- 5 steps to disconnect
- Visualize a secure box (see it clearly)
- See what it is made from. See the color. See how the lid is attached. See how it is locked.
- Open up the box and visualize putting that experience into the box. Close the box. Secure the lid. Lock it.
- Write on the lid “What I have placed in here will remain secure and safe until I come back. I will come back and do more with this late but until then it will remain safely inside this box”
- Practice using this tool to improve it’s effectiveness.
- Accept what is: We can make situations more difficult to tolerate by judging that it shouldn’t be that way, pretending that it what is isn’t, or being fixated on WHY. Even if it’s true that something shouldn’t have happened or that we wish it hadn’t, staying fixated on that can be a way of avoiding experiencing our negative feelings about what happened. Similarly, when we stay locked on the question of why this happened or why it happened to us we keep ourselves from processing through the painful feelings and moving forward. When we accept that something happened we are NOT saying it’s right that it happened or that it should have happened. We are simply owning that it did happen and now must be dealt with.
- Go through it: As Winston Churchill said, “If you are going through hell, KEEP GOING”. When we refuse to feel an experience it doesn’t go away, it gets put on pause. When we have an unpleasant emotion because it is appropriate to what happened, it is often best to experience the feeling. We are supposed to feel sadness and grief when someone or something we love dies. Those are appropriate feelings for the experience and experiencing those emotions is part of the grief process. Pushing them away or disconnecting from them will only hold us back.
- Regulate our response: The experience of something can be impacted by how we respond while experiencing it. In tip 1 we use our mind to impact our experience, in this tip we’re going to use our body to impact our experience. When we experience difficult feelings, our body responds in ways that are congruent with those experiences. When we are scared our bodies go into a danger response (for more on danger responses read this blog post). We can use breathing techniques that tell our body we are calm to help us move out of the danger response. Slow deep breaths in through our nose and out through our pursed lips like a whistle. Short pause.
Improving our distress tolerance helps us deal with unpleasant experiences and emotions more effectively. Building these skills in our every day life will also help us manage our PTSD. Healing of PTSD occurs within that space of distress tolerance (AKA our therapeutic window): connected to it and feeling it in manageable levels while not being overwhelmed by it. As we build our skills for being connected to and experiencing our everyday distresses we are learning tools that can be directly applied to managing our PTSD distress experiences when healing the trauma that is at the root of the PTSD. Healing PTSD is often best done with a trained trauma therapist.
I am a therapist in Austin Texas. I specialize in helping adults heal from difficult childhoods, childhood trauma, CSA (Childhood Sexual Abuse), sexual assault, PTSD (Post Traumatic Stress Disorder), and cPTSD (complex PTSD). If you are interested in working to improve your distress tolerance, resolve past trauma, or to treat your PTSD contact me to schedule your free 30-minute, in person, consultation to discuss how I can help you heal your history.